Spatially improved extended reach ultrasonic toothbrush

ABSTRACT

An ultrasonic toothbrush having spatially extended functionality to treat various oral diseases in addition to removing plaque and treating gingivitis is disclosed. In addition to the ultrasonically activated bristles, the toothbrush incorporates a multi directional ultrasound transducer system, which spatially irradiates the oral cavity with ultrasonic pressure waves, operational to loosen plaque, to remove periodontal bacteria from teeth and gums, and to simultaneously treat and destroy disease causing bacteria and bacterial chains on the inside surfaces of cheeks and lips, providing relief from Recurring Aphthous Stomatitis, Lichen Planus, and Mucositis. Various configurations are disclosed, including user removable and replaceable brush heads and ultrasound treatment heads. A motorized version featuring sonic frequency orbital vibration brush head and bristle tufts is described.

CROSS REFERENCE TO RELATED APPLICATIONS

This application claims the priority date and all other benefits of U.S.Provisional Application No. 61/994,817, filed May 16, 2014, the contentsof which are hereby incorporated by reference in their entireties as iffully set forth herein.

BACKGROUND OF THE INVENTION

1. Field of the Invention

This invention relates to toothbrushes and more particularlytoothbrushes utilizing sonic and ultrasonic acoustic mechanism toincrease the effectiveness of the toothbrushes and to provide forenhanced oral hygiene.

2. Description of Prior Art

Some of the early art of powered toothbrushes attempted to increase thespeed of bristle vibrations by various sonic frequency and ultrasonicfrequency means. These devices are exemplified by U.S. Pat. No.3,335,443 by Parisi, U.S. Pat. No. 3,809,977 by Balamuth, and U.S. Pat.No. 4,192,035 by Kuris. These proposals did not utilize ultrasonicpressure waves to impact upon the plaque and periodontal bacteria on theteeth and gums; they were merely faster vibrating mechanical toothbrushdesigns. It is not known if any of these patents were utilized incommercially available toothbrushes.

The first commercially available ultrasonic toothbrush utilizingultrasonic pressure waves to help remove plaque and destroy periodontalbacteria was based on U.S. Pat. No. 5,138,733 by Bock, which contained apiezoelectric transducer in the tip of the brush head to generate theultrasonic pressure waves, which were transmitted through the bristlesto teeth and gums. While this was a great leap forward in toothbrushdesign, it was not optimal since a significant portion of the ultrasoundenergy generated by the piezoelectric transducer were lost due tovarious structural ultrasound attenuation mechanisms. Materialinterfaces are not 100% efficient. Each material interface that theultrasound wave has to travel through, such as the adhesive totransducer interface and the adhesive to housing interface securing thetransducer in the housing, the housing to the brush head interface, andthe brush head to the bristle interface are reflecting some of theultrasound energy back toward the transducer. In addition, the longaspect ratio thin bristles attenuated some of the ultrasonic energygenerated by the piezoelectric transducer. In both U.S. Pat. No.5,138,733 and U.S. Pat. No. 5,369,831 also by Bock, the transmission ofultrasound toward the back of the brush head was also greatly reduceddue to the numerous surface interfaces and thick housing materials,which attenuated the ultrasound energy toward the back side of the brushhead. Nevertheless, U.S. Pat. No. 5,138,733 and U.S. Pat. No. 5,369,831still represented the best solution for ultrasonic toothbrushes at theirtime.

U.S. Pat. No. 7,269,873 B2 by Brewer et. al, entitled “Ultrasonictoothbrushes employing an acoustic waveguide” represents the nexttechnological improvement in the art. The Brewer patent is essentially amodification of U.S. Pat. No. 5,138,733 by Bock, wherein Brewer providesan improvement in the efficiency of the transmission of the ultrasonicpressure waves from the transducer through the toothpaste and the fluidsin the mouth to the teeth and gums by the addition of a waveguide, whichis more efficient in transmission of the ultrasonic waves toward teethand gums than the bristles in U.S. Pat. No. 5,138,733 by Bock. However,the waveguide suggested by Brewer while more efficient than the bristlesin Bock's disclosure and practice, still attenuates the ultrasonicenergy produced by the transducer, both by the waveguide to transducerinterfaces and the waveguide itself. In an attempt to maximize theultrasonic energy output from the acoustic waveguide toward teeth andgums Brewer utilizes an ultrasound-reflecting element (see FIG. 1 item28) or an alternative air-gap (see FIG. 4) on the back of the ultrasoundtransducer. Air-gaps are known in the art to reflect and stoppropagation of ultrasound pressure waves. Both the ultrasound reflectingelement and the air-gap are isolating ultrasound wave emission from theback of the brush-head and from the lips and cheeks.

U.S. Pat. No. 7,849,548 B2 by Bock represents the next technologicalimprovement in ultrasonic toothbrushes. In his disclosure Bockeliminates all structural attenuation of ultrasound energy emitted bythe piezoelectric transducer toward teeth and gums by bringing thetransducer out of the brush head and getting it in direct contact withthe toothpaste and the fluids between the toothbrush and the teeth andthe gums, greatly enhancing the efficiency and efficacy of the design.There are no surface interfaces or any other material to attenuateultrasound energy between the transducer and the fluids of the oralcavity on the side of the bristles and teeth and gums. However,similarly to Brewer, Bock also proposed an ultrasound reflecting closedcell foam (see FIG. 1 item 40) on the back of the ultrasound transducer,which isolates ultrasound emission from the back of the toothbrush andthe lips and cheeks.

Both U.S. Pat. No. 7,269,873 B2 by Brewer et. al, and U.S. Pat. No.7,849,548 B2 by Bock disclose the heretofore standard constructiontechniques of the ultrasound transducer art throughout history, whereinthe objective always has been to maximize ultrasound emission from thesingle “working” side of the transducer by the application of ultrasoundreflecting materials and ultrasound reflecting air-gaps on thenon-working “back” side of the transducer. This ultrasound emissionmaximization from the single working side significantly reduced and mostoften completely eliminated ultrasound emission from the non-workingback side of the transducers.

U.S. Patent Application US 20130115571 A1 by Emecki discloses a devicewherein the toothbrush bristles are directly attached to one side of thetransducer to act as waveguides and transfer the mechanical oscillationenergy to the teeth. While Emecki does not describe the constructiondetails of the brush head, it is clear from FIG. 2 of the disclosurethat the mechanical oscillations are limited or completely eliminated byan air-gap or reflecting material on the back side of the transducer.Emecki's entire teaching and effort is focused on maximizing emission ofmechanical oscillations into the bristles.

While progress to date was significant, the fact remains that theultrasound toothbrush art has been focused on and only been successfulto date to effectively remove plaque and periodontal bacteria from theteeth and gum surfaces.

Some people are suffering from various oral diseases, such as RecurrentAphthous Stomatitis (RAS), commonly referred to as canker sores, LichenPlanus (LP) a chronic inflammatory disease with painful erosive orulcerative areas mostly in the cheeks opposite to the teeth, andMucositis (painful ulcerative lesions) caused by AnticancerChemotherapy, which are appearing on the buccal and labial mucosa, theinside surfaces of the cheeks and the lips.

The ulcerative lesions of Mucositis are colonized by opportunisticbacterial micro organism, which create secondary infections making thealready difficult to handle Chemotherapy process even less tolerable.There is evidence in the scientific community to support that RAS and LPare an aberrant immune response to the presence of oral flora. Thus abeneficial effect from the reduction in the oral bacterial load would beanticipated. Treatment with immunosuppressive agents, such as systemicor topical corticosteroids, will reduce RAS and LP activity in mostpatients with the disease. Unfortunately, this reduction is transient,and lesions quickly recur when treatment is discontinued. Because of thesignificant systemic side effects of corticosteroids, such as glaucoma,fluid retention, increased blood pressure, mood swings, osteoporosis,and more, the treatments with immunosuppressive corticosteroids cannotbe tolerated for an extended period of time; the immunosuppressivecorticosteroids treatments are only short-term temporary solutions.Therefore an effective therapeutic modality that is well tolerated for along time would be of great value.

The ultrasonic toothbrush is a well-tolerated modality without any sideeffects. The limited amount of Ultrasound emitted from the backside ofthe first generation ultrasonic toothbrush based on U.S. Pat. No.5,138,733 has been demonstrated by clinical studies to have a modestbeneficial effect (46% reduction in the duration of RAS lesions as wellas of decreasing the number of lesions that develop) on recurrentaphthous stomatitis. This modestly beneficial effect of the firstgeneration ultrasonic toothbrush was limited by the structuralattenuation of the ultrasonic pressure waves escaping through thebackside of the brush head, contacting the inside surfaces of the lipsand cheeks.

So, even the latest state of the art ultrasonic toothbrushes are notoptimally efficient to attack and destroy the various oral bacteriaresiding and colonizing on the inside of the lips and cheeks opposite toteeth and gums, which are causative of RAS and LP.

The art is still missing the opportunity to conveniently andconcurrently with removing plaque and periodontal bacteria from teethand gums, also to provide relief of RAS and LP and improve the healthstatus of people suffering from RAS and LP.

In summary, RAS and LP are both an aberrant immune responses related tooral flora, still waiting for an effective relief, by a well-toleratedmodality, without immunosuppressive agents and their systemic sideeffects.

The ultrasonic toothbrush being a well-tolerated modality is a goodcandidate, but the quest for a multi purpose spatially highly effectivedevice is still not fulfilled.

SUMMARY OF THE INVENTION

Responding to the above described needs the goals of this invention isto provide methods and devices, which in addition to removing plaque andperiodontal bacteria from teeth and gums also effectively treat variousoral health and hygiene problems, such as RAS and LP rooted in anaberrant immune response to the presence of oral flora on the lips andcheeks, and to provide relief from Mucositis by destroying theopportunistic bacterial micro organism colonizing in the Mucositislesions, conveniently and concurrently with the daily tooth-brushingregimen.

The invention achieves these goals by the development and disclosure ofthe new methods and a new spatially improved ultrasonic toothbrushemploying a high efficiency non-attenuated novel piezoelectrictransducer mounting system wherein the transducer is exposed on twosides of the brush head. The piezoelectric transducer is exposed andprotrudes between the bristles in direct contact with the toothpaste andthe oral fluids toward teeth and gums to treat the periodontal bacteriaand remove plaque from teeth and gums, and equally importantly, it isalso exposed on the back of the brush head in direct contact with theoral fluids and with the inside surfaces of the lips and cheeks,delivering highly efficient non-attenuated ultrasound pressure waves totreat the oral flora and the tissues of the oral cavity opposite toteeth and gums. The intensity of these non-attenuated ultrasoundpressure waves are more than double of the first generation ultrasonictoothbrush both on the bristle side and particularly on the back side ofthe brush head. Contrary to the temporary treatments of RAS and LP byimmunosuppressive corticosteroids, the ultrasound modality is awell-tolerated long-term modality for years of daily application withoutlimitation, providing long-term relief from RAS, LP, and Mucositis in apatient.

The new method comprises of the treatment of RAS, LP, and Mucositislesions of the oral cavity by subjecting the oral flora colonizing inthe lesions to ultrasonic pressure waves between 20 kHz and 20 MHzfrequency, more typically within 750 kHz and 2 MHz frequency, at anon-attenuated intensity from 0.02 to 0.5 W/cm², more typically within0.035 to 0.150 W/cm² either concurrently, in conjunction with, orindependently of the daily tooth brushing regimen.

Accordingly, the new spatially improved ultrasonic toothbrush inventioncomprises a handle portion and a brush head portion. The brush headportion supports the bristle tufts and a piezoelectric ultrasoundtransducer, which is protruding from the head toward teeth and gumsbetween the bristle tufts on one side and protruding though the headtoward the internal surfaces of cheeks and lips on the opposite side ofthe bristle tufts. The handle portion contains a battery pack, anelectronic motor to generate sonic frequency tactile vibrations of thebrush head portion, an electronic control module to generate theultrasonic frequency current to energize the ultrasound transducer andto provide control of the other functions in the toothbrush such asmotor speed control, and battery charge control. The toothbrush systemmay also include a battery charging stand to provide the primary currentfor charging the battery in the handle, usually by conductive currentmeans.

The ultrasound transducer being exposed directly to toothpaste and thedental fluid in the oral cavity on both sides of the brush head, inbetween the bristles on one side and opposite to the bristles on theother side is one of the major inventive steps of the invention. Thedirect exposure of the transducer to the dental fluids completelyeliminates any structural attenuation of the ultrasound energy before itis transmitted to the dental fluids, the teeth and gums, and thesurrounding surfaces of the dental cavity.

It has been shown in laboratory studies that without physical contact bythe bristles even the highly attenuated ultrasound pressure wavesemitted by the first generation ultrasonic toothbrush from a 5 mmdistance through Brain Heart Infusion broth simulating gingival fluids(a) ruptured the Streptococcus Mutans bacterial chain, (b) reduced thethickness of the biofilm on the enamel surface, and (c) damaged the cellwall of Streptococcus mutans. The results showed that ultrasound alsohas some influence on Streptococcus mutans cell wall and intracellularcomponents, suggesting that ultrasound inhibits the adherence ofStreptococcus mutans on enamel surfaces. This is the mechanism thatmakes an enhanced removal of plaque possible by the bristles of thefirst generation ultrasonic toothbrush.

The present invention transmits more efficient and significantly higherintensity non-attenuated ultrasound pressure waves to tissues,generating mild cavitation in the fluids of the oral cavity. Incombination with the dynamic fluid motion generated by the sonicfrequency bristle vibration, the invention significantly improves theability of the toothbrush to remove substantially all plaque from teethand gum surfaces and to destroy bacterial colonies further beyond thereach of the bristles by as much as 7 to 10 mm in between teeth and intoperiodontal pockets.

The invention's non-attenuated ultrasound pressure waves from the backside of the brush-head treat, damage, interrupt and disorganize thebacterial colonies residing on the inside surfaces of the cheeks andlips of the oral cavity, mitigating the effects of RAS and LP andMucositis to the extent that was not previously possible in the art.

The invention, without any extra effort by the user, extends the dailytooth-brushing regimen into a previously unavailable complete oralhygiene regimen.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 shows a longitudinal cross section and a schematic of theinvention consisting the brush head portion incorporating the tufts ofbristles and the exposed ultrasonic transducer, and the handle portioncontaining the driving motor, electronic controls and a battery.

FIG. 2 shows the cross section of the brush head and exposure of thenon-attenuated piezoelectric ultrasound transducer.

FIGS. 3A and 3B shows multi element transducer configurations to extendnon-attenuated transducer contact areas with the mucosa.

FIG. 4 shows side cross sectional view of a removable brush headassembly.

FIG. 5 and FIG. 6 show two cross sectional views of another embodimentof a removable brush-head assembly.

FIG. 7 and FIG. 8 shows two cross sectional views of two embodiments ofan ultrasound applicator head assembly.

DESCRIPTION OF THE PREFERRED EMBODIMENTS

In the title and in the following discussion the term “spatiallyimproved” refers to the multi-directional effectiveness of a toothbrushin space versus the conventional toothbrush, which is effective only onone side, which is toward the bristles.

The term “ultrasound” and “ultrasonic” and “ultrasonic pressure waves”refer to acoustic energy in either continuous wave ultrasound orrepetitive burst type ultrasonic modality having an operating frequencyof 20 kHz and above. References made to “sonic” and “sonic vibrations”utilized in toothbrushes are referring to physical vibrations oroscillating motions significantly below the 20 kHz ultrasonic threshold,typically in the range of 100 to 500 Hertz. The term “cavitation” inassociation with the toothbrush refers to the generation and/ordispersion of bubbles and the interaction between the sonic orultrasonic energy and vibrations with the bubbles within the oralfluidic environment. The term “structural attenuation” in associationwith ultrasound refers to the attenuation effects of the various surfaceinterfaces and materials commonly used for housing the ultrasoundtransducers and for transmitting ultrasound from the transducer to theanatomy in ultrasonic toothbrushes and other ultrasonic applications.

The damaging effects of ultrasound on bacteria and bacterial coloniesand rendering bacterial colonies ineffective are well known anddocumented in the scientific community. Clinical and laboratory studiesof earlier generation ultrasonic toothbrushes cited herein are only asmall set of examples of the effectiveness of the ultrasound emitted bythe toothbrush on the bacterial colonies and plaque. It is well knownthat the effectiveness of ultrasound is related to the intensity of theapplication, so it is important to limit energy losses and maximize theavailable intensity from an ultrasound transducer within the limitationof the tissue-heating threshold.

The invention of the spatially improved extended reach ultrasonictoothbrush 30 in a preferred configuration is shown in FIG. 1 and FIG.2. The toothbrush 30 comprises of a handle portion 32, a neck portion34, and a brush-head portion 36 constructed of a rigid or semi rigidplastic material. The handle portion 32 contains a battery pack 38, anelectronic control module 40, and an electric motor 42 with anoff-center weight 44 mounted on the shaft of the motor 42. Thebrush-head portion 36 contains an ultrasound transducer 46 and one ormore bristle tufts 48.

The battery pack 38 is typically a multi-cell rechargeable battery ofNiCd or NiMH chemistry system providing approximately 4.8 VDC to theelectronic control module 40. The electronic control module 40 hasmultiple functions. It controls the electric motor 42 to produce variousspeed sonic frequency orbital vibrations 52 typically between 100 Hz and500 Hz to the preference of the user, or no vibration when theapplication calls for the toothbrush to emit only ultrasonic pressurewaves 50 without sonic frequency bristle vibrations. The electroniccontrol module 40 generally will boost the battery voltage by a voltagemultiplier circuit to the range of 9.6 VDC to 16.0 VDC in conjunctionwith generating the ultrasonic frequency current between 20 kHz and 20MHz frequency, more typically within 750 kHz and 2 MHz frequency, forenergizing the ultrasound transducer 46.

The brush-head portion 36 houses the bristle tufts 48 and the ultrasoundtransducer 46. The ultrasound transducer 46 is positioned within andprotrudes from the brush-head 36 in two directions to provide spatialradiation of ultrasound pressure waves 50 without any structuralattenuation of the spatially radiating ultrasound energy.

The transducer 46 protrudes from the brush-head 36 between the bristletufts 48 toward teeth and gums on one side and protrudes though thebrush-head 36 on the opposite side of the bristle tufts 48 toward theinternal surfaces of the cheeks and lips.

The transducer 46 is typically constructed of one or more elements ofhard piezoelectric materials, such as PZT-4 or PZT-8 Lead ZirconateTitanate composition ceramics. The PZT-4 material is a particularly goodcandidate for the toothbrush application since it is capable ofproducing large mechanical drive amplitudes while maintaining lowmechanical and dielectric losses. However various other transducermaterials are also available in the art, such as single crystalsilicones, capacitive micro-machined materials, electrostatic polymers,and more will be available in the future to construct an ultrasonictransducer. When energized by the ultrasonic frequency current suppliedby the electronic control module 40 through the interconnecting wiring56 to the ultrasound transducer 46 the transducer 46 expands andcontracts in tune with the ultrasonic frequency current, producing andtransmitting ultrasound pressure waves 50 spatially into the surroundingand contacting materials, the toothpaste, the oral fluids, and thetissues of the oral cavity. To assure the best possible intimate contactwith and transmission of the non-attenuated ultrasound pressure waves 50into the lips and the cheeks, the brush head surface 54 opposite to thebristles 48 is constructed with a curved configuration and theultrasound transducer is exposed at the peak of this surface. While FIG.2 depicts the simplest transducer configuration constructed of a singleelement, other advanced multi-element configurations are possible.

FIG. 3A depicts a two-element straight “T” shape ultrasound transducer58 while FIG. 3B depicts a curved “T” shape ultrasound transducer 60illustrative of numerous configurations possible to increase contactareas with the mucosa of the lips and cheeks to further widen thespatial feature of the ultrasonic toothbrush, and not to miss thesometimes small but painful lesions of RAS and LP and Mucositis.

FIG. 4 depicts a removable brush-head assembly configuration of theinvention. The removable brush-head assembly 70 comprises asubstantially rigid elongated structural member 72 having a base portion74 designed for secure attachment to a mating 73 portion of thetoothbrush handle, a brush-head portion 76 housing one or more bristletufts 48 and an ultrasound transducer 46. The ultrasonic frequency powerto energize the transducer 46 is provided by an ultrasonic frequencycurrent generator located in the toothbrush handle through a connectorset 82 and connecting wiring 84.

The ultrasound transducer 46 protrudes from the brush-head portion 76 intwo directions to provide spatial radiation of ultrasound pressure waves50 without any structural attenuation of the ultrasound energy. Thetransducer 46 protrudes from the brush-head 76 between the bristle tufts48 on one side and protrudes though the brush-head 76 on the oppositeside of the bristle tufts 48.

FIG. 5 and FIG. 6 depict another embodiment of a removable brush-headassembly 90. In this embodiment the brush-head assembly 90 comprises asubstantially rigid elongated tubular stem 92, which slides over andsecures on a mating shaft 95 of the toothbrush handle, a brush-headportion 76 housing one or more bristle tufts 48 and an ultrasoundtransducer 46. The ultrasonic frequency power to energize the transducer46 is provided by an ultrasonic frequency current generator located inthe toothbrush handle connecting through a spring loaded slidingconnector set 96 located in a slot 98 in the tip of the mating shaft 95and connecting wiring 84.

The ultrasound transducer 46 protrudes from the brush-head portion 76 intwo directions to provide spatial radiation of ultrasound pressure waves50 without any structural attenuation of the ultrasound energy. Thetransducer 46 protrudes from the brush-head 76 between the bristle tufts48 on one side and protrudes though the brush-head 76 on the oppositeside of the bristle tufts 48.

FIG. 7 depicts a cross section of a removable ultrasound applicator headassembly 37 configuration of the invention, having a one-elementultrasound transducer 47. The removable ultrasound applicator headassembly 37 has an identical construction as the removable brush-headassemblies 70 and 90 shown in FIG. 4 and FIG. 5 respectively, with theexception that the removable ultrasound applicator head assembly 37 doesnot contain any bristles. All construction notes contained in thedescriptions of FIG. 4 and FIG. 5 of the removable brush-head assemblies70 and 90 are applicable to the removable ultrasound applicator headassembly 37 with the exception of references to the bristles.

The purpose of the removable ultrasound applicator head assembly 37 isto provide an optional accessory for the ultrasonic toothbrush to applynon-attenuated ultrasound treatment for RAS, LP, or Mucositis lesions atany time, independently from the daily tooth-brushing regimen. Theultrasound transducer 47 is exposed at the peak of the curved surface 54of the applicator head assembly 37 and the ultrasound pressure waves 50are conducted from the non-attenuated transducer to the bacterial floraby the oral fluids without the need for toothpaste.

FIG. 8 depicts a cross section of a removable ultrasound applicator headassembly 37 having a curved two-element ultrasound transducer 61 adoptedto increase the contact surface between the transducer 61 and thelesions in the oral cavity. All other construction notes of FIG. 7 areapplicable to FIG. 8 also.

All of the patents and publications cited herein and in the appendedInformation Disclosure Statement are hereby incorporated by reference intheir entireties.

While the preceding description contains numerous specificities, theseshould not be construed as limitations on the scope of the invention,but rather as an exemplification of a preferred and additionalembodiments thereof. Skilled artisans will readily be able to changedimensions, shapes, and construction materials of the various componentsdescribed in the embodiments and adopt the invention to all types ofsonic and ultrasonic energy applications. Accordingly, the scope of theinvention should be determined not by the embodiments illustrated, butby the appended claims and their legal equivalents.

What is claimed:
 1. An ultrasonic toothbrush comprising: a) a brush headportion having multiple bristle tufts composed of a plurality ofbristles and at least one ultrasound transducer protruding from saidbrush head portion between the bristles on one side and mounted flushwith said brush head on an opposing side, said ultrasound transducerradiating non attenuated ultrasound pressure waves in multipledirections toward teeth and gums on one side, and toward inside surfacesof cheeks and lips of an oral cavity on an other side, and coupling saidnon attenuated ultrasound pressure waves by a dentifrice and fluids insaid oral cavity simultaneously in said multiple directions to saidteeth and gums and said inside-surfaces of the cheeks and lips; b) ahandle portion containing means generating ultrasonic frequencyelectronic current and connecting means of said ultrasonic frequencyelectronic current to energize said ultrasound transducer located insaid brush head portion.
 2. The ultrasonic toothbrush of claim 1,wherein the multi-directional ultrasound pressure waves radiated by saidtransducer are non attenuated and operating between 20 kHz and 20 MHzfrequency and producing a non attenuated ultrasound intensity of 0.02 to0.5 W/cm².
 3. The ultrasonic toothbrush of claim 1 or 2, wherein thesaid multi-directional and non-attenuated ultrasound pressure wavesradiated by said transducer are operative to damage and reduceeffectiveness of disease causing bacteria and bacterial colonies in theoral cavity.
 4. The ultrasonic toothbrush of claim 1 or 2, wherein theultrasound transducer comprises at least two transducer elementsradiating ultrasound pressure waves, one said transducer elementradiating toward said teeth and gums, another said transducer elementradiating toward the inside surfaces of the cheeks and lips of the oralcavity.
 5. The ultrasonic toothbrush of claim 1 or 2, additionallycomprising a motor secured to a structure of said handle portion havingmeans to generate orbital vibrations of said handle portion and saidbrush head portion.
 6. The ultrasonic toothbrush of claim 5, wherein afrequency of said orbital vibrations is between 100 Hz and 500 Hz. 7.The ultrasonic toothbrush of claim 5, further comprising means toselectively generate orbital vibrations or not to generate said orbitalvibrations of said handle portion and said brush head portion accordingto the desires of the user.
 8. A method of treating lesions of an oralcavity by subjecting an oral flora colonizing in said lesions tomulti-directional non-attenuated ultrasound pressure waves between 20kHz and 20 MHz frequency and 0.010 to 0.500 W/cm^2 intensity radiatedfrom an ultrasonic toothbrush comprising: a) a brush head portion havingmultiple bristle tufts composed of a plurality of bristles and at leastone ultrasound transducer protruding from said brush head portionbetween the bristles on one side and mounted flush with said brush headon an opposing side, said ultrasound transducer radiating non attenuatedultrasound pressure waves in multiple directions toward teeth and gumson one side, and toward inside surfaces of cheeks and lips of the oralcavity on an other side, and coupling said ultrasound pressure waves bya dentifrice and fluids in the oral cavity simultaneously in saidmultiple directions to the teeth and gums and said inside surfaces ofthe cheeks and lips irradiating said lesions by said ultrasound pressurewaves operative to damage disease causing bacteria and to disruptdisease causing bacterial colonies residing in said lesions; b) a handleportion containing means generating ultrasonic frequency electroniccurrent and connecting means of said electronic current to energize saidultrasound transducer located in said brush head portion.
 9. The methodof claim 8, wherein the treatment of said lesions is executedconcurrently with a tooth-brushing regimen.
 10. The method of claim 8,wherein the said multi-directional non-attenuated ultrasound pressurewaves administered are between 750 kHz and 2 MHz frequency at anintensity of 0.035 to 0.150 W/cm².
 11. The method of claim 10, whereinthe treatment of said lesions is executed concurrently with atooth-brushing regimen.
 12. An ultrasonic toothbrush comprising: a) abrush head portion having at least one bristle tuft composed of aplurality of bristles and at least one ultrasound transducer protrudingfrom said brush head portion between the bristles on one side andmounted flush with said brush head on an opposing side, said ultrasoundtransducer comprises of at least two transducer elements radiating nonattenuated ultrasound pressure waves in multiple directions, one saidtransducer element radiating toward teeth and gums, another saidtransducer element radiating toward inside surfaces of cheeks and lipsof an oral cavity and coupling non attenuated ultrasound pressure wavesby a dentifrice and fluids in the oral cavity simultaneously in saidmultiple directions to the teeth and gums and said inside surfaces ofthe cheeks and lips; b) a handle portion containing means generatingultrasonic frequency electronic current and connecting means of saidultrasonic frequency electronic current to energize said ultrasoundtransducer located in said brush head portion.